宫外水是导致下胃肠道出血的原因
Abdulrahman Qatomah1,2, Sulaiman Almushir1, Faisal Aljohani2,3
1Division of Gastroenterology and Hepatology, McGill University Health Centre, Montreal, QC, Canada.
Case reports in gastrointestinal medicine
|June 26, 2023
概括
宫外静脉,在门高血压中引起胃肠道出血的罕见原因,可以发生在胃肠道的任何地方. 这种病例突出显示了子宫外状静脉,在结肠镜检查后呈现为直肠出血.
科学领域:
- 胃肠病学 胃肠病学
- 血管医学 血管医学
- 诊断成像 诊断成像 诊断成像
背景情况:
- 宫外静脉代表了 portal高血压患者中静脉出血的一小部分 (1-5%).
- 这些血管异常可以在胃肠道的任何地方表现出来,包括小肠,结肠和直肠.
研究的目的:
- 报告一个异宫 varices 的病例,呈现为显著的直肠出血.
- 为了说明CT血管学在识别这些罕见的血管异常方面的诊断效用.
- 强调在患有无法解释的胃肠道出血的患者中考虑子宫外变节的重要性.
主要方法:
- 一名59岁的男性患者呈现了直肠出血.
- 最初的调查包括胃镜检查 (阴性) 和最近的结肠镜检查与活检.
- 进行计算机断层扫描血管造影 (CT血管造影) 来评估出血的来源.
主要成果:
- CT血管造影显示,右下象限有一个大型的带系统分流,在右下象限有广泛的附带血管.
- 这些发现强烈暗示了眼内有异位静脉的存在.
- 患者呈现的直肠出血被归因于这些已确定的宫外.
结论:
- 宫外水可以出现严重的直肠出血,模仿其他下胃肠道病理.
- 脑电图血管造影是识别子宫外静脉的复杂血管解剖学的关键诊断工具.
- 早期诊断和适当的治疗对于患有异位出血的患者至关重要.
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